Dimensions Worcestershire Domiciliary Care Office

Dimensions Worcestershire and Oxfordshire is a domiciliary care service providing personal care and supported living services for people with learning disabilities or autistic spectrum disorder. The provider currently supports 176 people living in their own homes and in supported living settings in the community. We inspected one of the supported living services where four people were living.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People received their medicines as prescribed by trained staff who regularly had their competencies assessed.

Infection prevention measures had been established. Staff had a good understanding of these procedures and confirmed they were provided with sufficient supplies of PPE.

The registered manager had quality assurance systems in place to monitor the overall quality of the service provided to people. These systems had led to improvements in the quality of the service being provided to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. The management had developed a person-centred approach to each person’s care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 11 December 2017)

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about medicine management. The overall rating for the service has not changed following this targeted inspection and remains good.

Targeted inspections do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dimensions Worcestershire & Oxfordshire Domiciliary Care Office on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection December 2015, the service was rated Good. At this inspection on 21 and 22 November 2017 we found the service remained Good.

Why the service is rated Good

People continued to receive care which protected them from avoidable harm and abuse. Risks to people’s safety were identified and measures were in place to help reduce these risks. When people required support to take their medicines this only happened when staff had received the training to do so. Regular checks on staff practices were undertaken to support people’s safety.

Staff were available to respond to and meet people's needs safely without people feeling rushed. Recruitment checks were completed on potential new staff to make sure they were suitable to support people in their own homes. People were involved in the recruitment of staff, who would be potentially supporting them.

People were provided with care which continued to be effective in meeting their particular needs. Staff had received training to provide them the skills and knowledge they needed to provide the right care and support people required.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice

Staff asked people's permission before they assisted them with any care or support. People's right to make their own decisions about care and how they were supported by staff was respected. When needed, arrangements were in place to support people in remaining in good health and have enough to eat and drink. People were assisted to choose and prepare food menus so their independence was maitianed.

People continued to receive support from staff that had a caring approach. People knew the staff that supported them and had good relationships with them. People felt involved in their own care and staff listened to how they preferred their care and support to be delivered. Staff respected people's privacy and dignity when they supported them and promoted their independence. People were supported to follow their own interests and hobbies.

People were provided with care and support which was individual to them. Their care and support needs were kept under review and staff responded when there were changes in these needs.

People were encouraged to raise concerns and make complaints and were happy these would be responded to. The management team used feedback from complaints and questionnaires to assist them in identifying areas of improvements for the benefit of people. The provider arranged forums throughout the year so people could express their opinions on the service delivered.

Staff were happy in their work and were clear about their roles and responsibilities. There was an ethos of continuously looking for improvement of the service delivered.

There was a clearly defined management structure which had changed since our previous inspection. People felt listened to when they provided feedback about the service they received and knew about the changes. The management team worked well together and developed systems so they continued to be effective and responsive in assessing and monitoring the quality of the service provided.

During this inspection we spoke with the service manager and the deputy service manager. We also spoke with three support workers and two people who received personal care who came into the office during the inspection.

Following our inspection we spoke with one person who used the service on the telephone and with two relatives of people who used the service. We also spoke with another two members of staff who visited people to provide care.

People we spoke with were complimentary about the care and support they or their relative had received. We were told that consent was gained prior to the provision of care. One relative told us that they were: 'Confident' in the care provided and that they were: 'Very happy with the situation'. Another relative described the staff as: 'Excellent'. A member of staff told us that the provider: 'Tends to get staff who match the support people need'.

Staff had been recruited in an appropriate way and checks had been undertaken to make sure that they were suitable to care for people who used the service.

We saw that staff had received training and support which enabled them to care for people who used the service. One member of staff described the service manager as: 'Very approachable'.

The provider had systems in place to enable them to monitor the quality of the service provided. This was to make sure people received appropriate care. The registered manager was aware of where improvements in the service were needed.

People were treated with dignity and respect in their own homes. People who used the service told us they expressed their views on how they wanted to maintain their independence and care workers we spoke with told us how they supported people in their choice.

People were complimentary about the care and support people received. One person we met had limited communication, however he used positive gestures when asked questions about his care. Another person said, 'I find them very friendly'.

People were safeguarded as the provider had taken steps to ensure any potential instances of abuse could be identified and reported. Care workers we spoke with told us they felt supported by the manager to take appropriate action where required.

People were cared for, or supported by a sufficient number of care workers who could meet their care requirements.

We checked the provider had systems in place to measure the quality of the service being provided.